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An overview of an amplitude integrated EEG Setyo Handryastuti
Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007
Publisher : Indonesian Pediatric Society

Amplitude integrated EEG (aEEG) has been used widely in developed countries for years. It was initially developed by Maynard and Prior 1 in the early 1970s and later adapted for neonatal use by Hellstrom-Westas and Svenningsen 2 . It is especially used for monitoring term newborns after having survived from birth asphyxia.During the last decade neonatal health care in Indonesia has developed. Monitoring of physiological parameters such as ECG, heart rate, blood pressure, oxygen saturation and temperature have been integrated inour neonatal intensive care unit but equipments like continuous EEG monitoring and aEEG to evaluate brain function have not been well-known among our neonatologists and pediatricians. The consequence is the de-crease of infant mortality was not associated with the improvement of quality of life of the survivors due to neurodevelopmental problems caused by various diseases during neonatal period. In the future, it can be prevented by using brain function monitoring in high risk newbornfor neurodevelopmental problem in conditions such as hypoxic-ischemic encephalopathy (HIE), prematurity, neonatal seizures, central nervous system infection, metabolic disorders, intraventricular or intracranial bleeding and brain malformation. This article gives an overview about aEEG and its role in newborn.Â

Risk factors influencing the outcomes in infants with epilepsy Setyo Handryastuti; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Epilepsy in young children should always beconsidered as a symptom of an underlying brain disease. Parentsand caregivers often asked whether the seizures can be controlledand whether the epilepsy will affect the child development.Objective To find out risk factors influencing the outcomes ininfants with epilepsy.Methods This was a retrospective study on infants aged 1 monthuntil 12 months with recurrent epileptic seizures. We looked forthe risk factors as sex, types of medication, age at onset of seizure,epilepsy syndrome, etiology of epilepsy, history of neonatal seizure,first EEG features, and type of seizure for the last 6 month-period.The outcomes evaluated were controlled seizure and developmentalstatus.Results Hundred forty infants with epilepsy were reviewed,consisted of 84 (60%) infants with symptomatic epilepsy, and 56(40%) infants categorized as idiopathic. Forty-six (33%) infantshad controlled seizure, while 94 (67%) infants had uncontrolledseizure. Abnormal developmental status was found in 75 infants(54%). Abnormal developmental status was more found in infantswith polytherapy, age at onset of 1-4 months, symptomaticepilepsy, positive remote symptomatic, history of neonatal seizure,abnormality of first EEG, and uncontrolled seizure. Uncontrolledseizure of epilepsy was more found in infants with polytherapy,early age at onset (1-4 month old), symptomatic epilepsy, positiveremote symptomatic, history of neonatal seizure, and abnormalityof first EEG.Conclusion Our data indicate that classifying syndrome of epilepsythrough diagnostic screening and age of onset are important todetermine the outcomes.

The role of electroencephalography in neonatal seizures Setyo Handryastuti; A C van Huffelen
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

This paper gives an overview of the important role of EEG in detection, classification, management and prognosis of neonatal seizures.

Komplikasi intratemporal dan intrakranial pada otitis media akut anak Harim Priyono; Ratna Dwi Restuti; Andre Iswara; Setyo Handryastuti
Oto Rhino Laryngologica Indonesiana Vol 41, No 1 (2011): Volume 41, No. 1 January - June 2011
Publisher : PERHATI-KL

Background: Acute otitis media (AOM) is an acute inflammation in the middle ear caused by various factors such as blockage of Eustachian tube, infection and allergy. Purpose: The case report is to forewarn general practitioners and ENT specialists concerning AOM potentially causes intratemporal and intracranial complications. Case: We report an eleven-years-old girl with acute otitis media with intratemporal complications (labirynthitis and sensorineural hearingloss) and intracranial complication (meningitis). Case management: The recent management of acute otitis media with complications includes empiric antibiotics, analgesic, anti-inflammatory drugs and miringotomy with ventilation tube insertion. Conclusion: The accuracy of diagnosing AOM with complication depends on the clinical symptomps such as vertigo, fever, seizure, meningism and unconsciousness. The pneumatic otoscopy examination is the gold standard in diagnosing AOM. Our patient was given antibiotics for 14 days, anti- inflamation and myringotomy with ventilation tube insertion procedure. Keywords: acute otitis media, intracranial complications, intratemporal complications Abstrak : Latar belakang: Otitis media akut (OMA) merupakan peradangan akut yang berlangsung di telinga tengah akibat berbagai faktor predisposisi seperti sumbatan tuba Eustachius, infeksi dan alergi.Tujuan: Kasus ini diajukan untuk mengingatkan dokter umum maupun spesialis THT mengenali gejala komplikasi OMA pada anak yang mempunyai potensi menimbulkan komplikasi intratemporal dan intrakranial. Kasus: Dilaporkan satu kasus OMA dengan komplikasi intratemporal (labirintitis dan tuli saraf) dan intrakranial (meningitis) pada anak perempuan usia 11 tahun.Penatalaksanaan: Penatalaksanaan otitis media akut dengan komplikasi intrakranial dan intratemporal mencakup pemberian antibiotik empiris, analgetik, anti-inflamasi dan tindakan miringotomi dengan pemasangan pipa ventilasi. Kesimpulan: Ketepatan dalam mendiagnosis OMA dengan komplikasi tergantung pada gejala klinis yang bisa dikenali seperti pusing berputar, demam, kejang, kaku kuduk dan penurunan kesadaran. Pemeriksaan otoskopi pneumatik merupakan gold standard dalam membantu diagnosis. Terapi untuk kasus ini terdiri atas antibiotik selama 14 hari, anti-inflamasi dan tindakan berupa miringotomi dengan pemasangan pipa ventilasi.Kata kunci: otitis media akut, komplikasi intrakranial, komplikasi temporal

The management of febrile seizures by pediatricians in Indonesia: adherence to 2016 Indonesian Pediatric Society recommendations and influencing factors Amanda Soebadi; Rivaldo Suhito; Setyo Handryastuti
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.119-28

Background Although febrile seizures are generally benign, judicious management is needed to prevent inadequate or excessive management. In 2016, the Indonesian Pediatric Society (IPS) issued Recommendations for the Management of Febrile Seizures, but it is unclear whether pediatricians follow these recommendations in their clinical practice. Objectives To evaluate adherence to the 2016 IPS Recommendations for the Management of Febrile Seizures amongst pediatricians in Indonesia, as well as factors influencing adherence. Methods An anonymous online questionnaire was distributed by e-mail to IPS member pediatricians. We collected data on age, year of completion of pediatric residency or subspecialty training, practice region, type of practice, number of febrile seizure patients managed per month, and history of attending teaching sessions on the recommendations. We scored participantsâ€™ adherence to the recommendations in terms of pharmacologic treatment, ancillary testing, and prognosis. We also analyzed the difference in scores according to participant characteristics. Results Of 308 participants, 247 (80%) obtained a total adherence score of 50% or more of the highest possible score. Median total adherence score was 63.2% (range 20.6% to 100%) of the highest possible score. Median adherence scores were significantly higher in pediatricians who were 31 to 60-years-old vs. >60-years-old (64.7% vs. 52.9%, P=0.004), completed their residency training within the past <10 years vs. >10 years (64.7% vs. 61.8%, P=0.034), practiced in hospitals vs. clinics or private practices (61.8% vs. 50.0%, P=0.006), were aware vs. unaware of the recommendations (64.7% vs. 52.9%, P=0.02), and had vs. had not read the recommendations (62.7% vs. 50.0%, P=0.01). Most participants (93.5%) reported the recommendations to be feasible in their settings. Obstacles to implementation included lack of medication availability (8/20), lack of time to read the recommendations (8/20), lack of awareness of the recommendations (2/20), and limited infrastructure (2/20). Conclusions Most pediatricians in Indonesia have moderately good adherence to the 2016 IPS Recommendations for the Management of Febrile Seizures. Awareness of the recommendations needs to be raised further and limitations in medication distribution and infrastructure need to be overcome for better adherence.

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